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Related Experiment Videos

Physician-attributable differences in intensive care unit costs: a single-center study.

Allan Garland1, Ziad Shaman, John Baron

  • 1Division of Pulmonary and Critical Care Medicine, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109, USA. agarland@metrohealth.org

American Journal of Respiratory and Critical Care Medicine
|September 16, 2006
PubMed
Summary

Intensivist physician practice patterns significantly impact healthcare costs, with substantial variation in resource use among doctors in intensive care units (ICUs). Higher spending did not correlate with improved patient outcomes like reduced length of stay or mortality.

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Area of Science:

  • Critical care medicine
  • Health services research
  • Medical economics

Background:

  • Healthcare practice variations are common, even in intensive care units (ICUs), and are not always explained by patient or illness factors.
  • Understanding physician-specific practice patterns is crucial for optimizing healthcare delivery and resource allocation.

Purpose of the Study:

  • To measure the variation in resource utilization among different intensivists within a single medical intensive care unit (ICU).
  • To determine if physician practice style influences patient outcomes such as length of stay and mortality.

Main Methods:

  • A prospective, noninterventional study was conducted in a medical ICU.
  • Data were collected from 1,184 consecutive patient admissions managed by nine intensivists over 14-day rotations.

Related Experiment Videos

  • Multivariate models analyzed the association between intensivist identity and daily discretionary costs, ICU length of stay, and hospital mortality, adjusting for patient and illness characteristics.

    • Main Results:

    • The intensivist's identity was a significant predictor of average daily discretionary costs (p < 0.0001).
    • No significant association was found between intensivist identity and ICU length of stay (p = 0.33) or hospital mortality (p = 0.83).
    • Average daily discretionary costs varied by 43% across intensivists, with a mean difference of $1,003 per admission between the highest and lowest resource-using groups.

    Conclusions:

    • Significant differences exist in resource consumption among intensivists for critically ill patients.
    • Increased resource use by intensivists was not linked to improved patient outcomes, such as shorter ICU stays or lower mortality rates.